For your safety and the safety of our staff we ask all requested forms to be mailed or faxed. you may mail your forms to 8316 Alrington Blvd., Suite 300, Fairfax, VA 22031. Our Fax number is 703-280-9350. Thank you for your cooperation.
FREE: Forms will be completed for free if brought with the child to the well check visit.
TIME: Forms take from 7 – 10 business days (Mon-Fri) to complete.
FEES: $10 for a single page form
$15 for multiple page form
RUSH FEE: There will be an additional $25 fee to have a form complete within 24 business hours (Mon -Fri).
Please Complete the parent portion of the form and include payment.
We will call you when the form is completed and ready for pick up.
You can pick up the form, or include a self-addresses, stamped envelope and we will mail the form to you.